Changes in gallstone morbidity in a community with decreasing frequency of cholecystectomies. A statistical study of the county of Stockholm, Sweden, 1969-1982.

From 1969 to 1982 there has been a continuous decrease in the cholecystectomy rate in the county of Stockholm, Sweden, from 265 per 100.000 population to 105. The change is greatest among young females. During the same period there has been a two-fold increase in gallbladder cancer. Although the total number of cases with common bile duct stones have decreased, they have increased in relation to the number of cholecystectomies. A similar trend is true for cases with and operations for acute cholecystitis. From 1970 to 1982 there has been a fairly constant number of cholecystographies and ultra sound scans of the biliary tract indicating that the diagnostic efforts have been unchanged, at least quantitatively. However, cases with positive diagnosis have decreased especially among young females. It is concluded that the decreased cholecystectomy rate in the county of Stockholm can be explained by a simultaneous decrease of the prevalence of gallstones, at least among the young, and a decrease of operations among those who have gallstones.